Vertebral haemangiomas in palaeopathology: skeletal evidence from Etruscan Italy

This research aims to provide a framework for identifying vestiges of vertebral haemangioma (VH), a benign tumour originating from the cells that form blood or lymphatic vessels, in archaeological human skeletal remains. The macroscopic alteration was observed in the fourth thoracic vertebral body of a female aged 2535 years at death from the necropolis of Pontecagnano (Salerno, Italy), dated to 725650 BCE; the adult individual was associated with the skeletal remains of an infant. Macroscopic assessment was combined with stereomicroscopy, micro-CT, and 3D reconstruction. Macroscopically, areas of cortical bone loss enabled evaluation of trabecular thickening and rarefaction. Radiographically, small punctuate areas of sclerotic bone resulting from the replacement of the normal cancellous bone by vertically oriented and thickened vertical trabeculae were typified as polka-dot on the axial plane and corduroy sign on the sagittal image. The bone alterations are considered pathognomonic of an intraosseous VH. This study, which describes one of the few cases of VH in the palaeopathological literature, highlights the importance of combining macroscopic assessment and advanced imaging techniques for the diagnosis of VHs in archaeological human skeletal remains.